Free healthcare in UK?

The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review

The impact of tort reform has been mostly positive but very mixed, and not exactly transformative in terms of cost. For the record, I’m not against it, but it is a modest step that has already taken place in many states.

 

How about general health care at no cost for the masses (citizens or legal immigrants only), but if you want Cadillac care, you can pay for that. If you want to claim health care is a civil right or human right, then our plan can’t work due to politics and economics. If that sounds like something that would be awesome, then the question is how do we get there?

 

The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review

So tell us what they should do vs what they have done.

 

The tort reform I’m talking about is well beyond anything considered by any state. No state has enacted any real meaningful tort reform. Further, state tort reform will never have any impact on insurance/health care costs. It has to be National.

 

As a general rule I would support this. The devil is in the details.

The UK has this to a degree. The problem is most people opt for the NHS, because that is where all the customers and providers are. It is hard to have a viable Cadillac system if most people are in the general system.

I don’t think health care is a human right, but I do think we have an obligation to take care of others, at least to a certain level.

 

Go on….

I am not opposed to this. I don’t really understand why federal is so much better, and I’m always amused then conservatives who typically purport to be for federalism and hate federal mandates advocate for federal mandates, but again, I’m not opposed.

 

You're arguing my point for me. Anyway, have a good father's day.

 

This isn’t a Dem/Pup issue. If you identify the problem as providing health care (not insurance like Obamacare) then the best solution (ignoring costs) is to just allow people to see any Dr, visit any clinic or hospital for no cost. No insurance, no co-pay. But we can’t ignore costs. That is the boogeyman. 100s of components make up this monster. Universal/national health care requires national regulations. National Tort reform is critical to this package. A single rogue state makes the whole system unworkable. Health providers pay a ridiculous insurance premium and pass that on to the consumer. OBGYNs have to carry a tail policy for 18 years after they retire. That is ridiculous. So ask yourself…what is more important: do you want FREE health care or do you want post care financial protection? You can’t have both together. So if you opt for the free health care, you opt out of pursuing legal action if your care was suboptimal. If you want to have those post care assurances, then you either buy a care policy (much like a trip insurance policy) or you opt into the Cadillac plan, where you pay for health care, and there is no (or little) tort reform. Much more details than I can put in post. This is a piece of a big puzzle, and all the pieces matter. There are many other cost reduction solutions to be had.

 

Our country can’t afford to provide medical care for the world. Period. That has to a line in the sand. As for the British model, it will never work because they have not solved the provider issue. Many puzzle pieces. There will always be a market for the Cadillac plan in the USA, and it is necessary for the political solution.

 

That works for me. Always happy to agree on things.

 

Wait, so your plan is to say poor people can't sue if a doctor screws up and harms them if they can't afford healthcare but rich people can if the same happens to them? Basically, you can purchase your right to damages? Do we even really need to game that out one step ahead to see the problems that would cause?

 

No. That is not what I said. I see what your problem is though. You can’t solve problems because you are too busy imagining problems. Our plan doesn’t provide care for poor people, it provides care to all Americans, without costs. You want a reach-around with your health care. Guess what, you don’t get it unless you want to pay extra…the same if you want bacon on your burger. Oh, guess what else- many of the most skilled Doctors will only be available to the rich, just like today. Are you going to be OK? Those people pay for their privileges, which makes the system work, and there is nothing wrong with that. But, good news is our plan will entice a good number of the top Docs to the system. Your perceived problem was recognized, analyzed, discussed and resolved by Doctors, Lawyers, Nurses, a few judges, hospital administrators, politicians, some rich and middle income folks, and a whole bunch of others.

 

Yeah, all of this means nothing and is just bluster substituting for substance. Can a person sue a doctor if they cause them to be permanently disabled if they received healthcare through your (not "our," nobody else is proposing this system for a large number of reasons) "free system?" If the answer is no, I correctly described your system. If the answer is yes, you are going to need to clarify your earlier remarks.

Putting even a modicum of critical thought to your proposal would be necessary to actually solve problems. See also, for example, the fact that you proposed outlawing pre-existing conditions without any manner of controlling for moral hazard. Proposing bad ideas isn't a solution.

 

Sorry buddy, you don’t get it. It’s not “my” system as many people much smarter that me contributed. It’s not “free”, because, like Unicorns, free does not really exist. You just don’t pay out of pocket for care. If you get care under this system, you give up your right to sue. You can buy care insurance, or you can go to the Cadillac plan and pay for your care. If you become permanently injured by a Dr while receiving your “free” medical care, you continue to get free medical care (so you have no damages for future care). But no pain & suffering, etc. Medical malpractice is statistically rare (I think less than 1% but it has been a while since I looked), and serious/permanent disability flowing from med mal is even rarer. Small price to pay for fixing the much bigger problem, and you can pay for coverage if it really matters to you)

 

Only the globalists/NWO/communist sheeple.

 

Okay, so I accurately described your system, you just wanted it framed as a brilliant idea to purposefully strip legal rights to people based on ability and willingness to pay. Framing is not the problem. Economics is.

At its core, there aren't many healthcare systems. You have single provider, single payer, pure free market, and hybrid free market/government pay or provided. You are simply proposing that we move from a hybrid free market/single payer system as we have now to a hybrid single provider/free market system and correspondingly creating an even more locked in two-tiered system. And you say it solves the problem. What problem, exactly, is being solved by switching from hybrid single payer/free market system to a hybrid single provider/free market system?

 

Dude, nothing that you just posted has any relationship to the reality of what the plan is that I have been discussing. Nothing. As for taking away legal rights, once again, you are too close minded to understand this issue based upon your criticism. In no way did I suggest that the plan would take away anyone’s legal rights. You are so angry, and so intent on trying to be correct, that you are not focusing on the macro issue that we are discussing. Instead, you are incorrectly focusing on a single micro component of a multifaceted proposal. You ignore the proposal has choices, so no one is taking anything from you. You choose. But I find it very interesting that you think it’s more important that a citizen have the right to file a lawsuit on the 1% chance that they may be subject to malpractice, then it is for that same citizen to have medical care in the first place. I think your priorities are a little F’ed up. Enjoy the rest of your day.

 

I don’t have a particular partisan lean on this issue. Conceptually I’ll mostly agree with what you outlined above, but it is easy to talk in broad conceptual details, much harder to outline specific policy that is workable and agreeable to most.

I will agree on national tort reform, but it would probably save somewhere between 2-4%. That’s certainly not nothing, but it is a one time savings and is less than the annual increase in any particular year. But I agree, we should do it.


So it seems like you are arguing for a two tier system, affordable for most and a premium plan. So who pays for the affordable option?

Could this not be handled via a Medicaid for all?

I am not clear on how you propose the poor getting care.

To have low cost health care, there are two extremes:

The issue with healthcare is you can either have an out of pocket a la carte system, which would introduce more price competition, but would be unaffordable for some people completely,’and for others only certain expensive options would be available. I know of no nation that has anything like this and I think almost nobody thinks this is acceptable, because they view health care differently.

Or, to control costs, you could have a tightly regulated insurance system, either single payer or a limited number of insurance providers, all working off regulated and common prices for most services across the board, and also allocating (rationing) care based upon need, because without rationing people will over consume. This can be a fully socialized model, like NHS, and tends to be the most cost effective because you’ve eliminated all of the pricing and reimbursement overhead in the system, but is also the least flexible as government manages the supply and execution and is not usually very good at doing that. Single layer provides more flexibility but still there will be some level of rationing. Or you can have insurance companies, maybe non profit or maybe profit, but they are working off of regulated prices and plans such that the provider and the insurance company are working under a common set of rules which lowers admin costs.

In between that you can have a combination of the above. What we have tends to be the worst of all worlds.

We can all say what we think is the nirvana system but we are a nation of many interests and we all won’t get what we want. ACA was an attempt to make progress recognizing that. It was far from perfect but was a step forward.

The bigger issue is the actual care model, and changing peoples lifestyle and health care habits. That is very difficult to do, but our healthcare system doesn’t even try.

As a starting point I’d say expand Medicaid expansion to all the states, and make Medicaid (or Medicare) a “public option” in the exchange, and a sliding scale for payment based upon need/resources.

I would say the Medicare model works reasonably well, you can go with Medicare standard, or you can go with a private Medicare advantage plans, plans which are pretty standardized and he’s not regulated. Set up sliding payment scales based upon need and fund the balance via a payroll tax or national VAT tax.

That solves the funding aspect but doesn’t address the more important moving more towards a preventative healthcare model vs reactive.

 

Of course it does. Which is why you aren't disputing anything that I am saying as being incorrect in terms of describing your plan.

But it would. You wouldn't have said those words, but you are pulling away the right of people to sue somebody for harming them, a legal right of a person in this country.

I am in no way angry. I have calmly stated this in a factual manner.

Guilty. Being correct is important. We should all strive for that.

Of course I am. I am discussing your proposal for healthcare. I am showing why it is not a good idea. You are utilizing flowery language to cover up for a combination of bad idea and limited knowledge of the specifics of how such a system would play out in the real world.

I just asked you what problem a hybrid single provider/free market system would solve that a hybrid single payer/free market system doesn't. You have yet to provide an answer to that inquiry. Hard to get more generalized than that.

Unless you have no money. I mean, by that standard ACA has choices too. You can absolutely choose to purchase private health insurance if you qualify for Medicaid. People don't because creating a choice literally nobody would consider for fairly obvious reasons is not really creating a choice.

I think it is very important for an individual to have healthcare. You have yet to demonstrate that your proposal would increase healthcare access compared to a single payer/free market hybrid system. And, despite not providing evidence of that, you want to strip anybody who can't afford private healthcare of their legal rights if they are injured by a practitioner. A solution not solving any problem.

 

If you go back and read my post from today, you will see one of my post, which opens the topic, and I state pretty clearly that the solution to our healthcare crisis, in my opinion, is to rethink healthcare. All of these terms and concepts that you were throwing out, there are limited to our current system. They have no place in our system that will actually function long-term and short-term. Let me cut to the end game here, which is probably the most important consideration. And you can use past history in Washington as a guideline for this. Anybody can have a solution to a problem that requires national implementation, but unless you have the votes to do it, and that requires political will, it is meaningless. All the good intentions in the world aren’t going to get you anywhere. That has always been the problem with healthcare in this country. The lawyers bar, the insurance, lobbyist, the pharmaceutical companies, they all are extremely powerful, because they control political votes. This is just one of many problems that have to be solved simultaneously in order to get a long-term solution. Obamacare does not fix anything. It is using an outdated model (for profit insurance) to fix a problem in healthcare that doesn’t really exist to the extent proclaimed. There are a multitude of problems in our healthcare system that need to be corrected, and none are more important than the other. The whole system needs to be fixed. This is why our healthcare system needs to be re-imagined. The Medicare system is a good general model, but it has way too many problems and short falls to make it a long-term solution. As you may or may not know, most healthcare providers despise Medicare. A workable system must attract and retain talent, remove bureaucracy, eliminate waste, maximize productivity, be accessible, reliable and excellent. It Hass to be fiscally responsible, and politically acceptable I know these sound like a bunch of meaningless buzzwords, but they are not. As for your comment on tort reform, you are right that are malpractice related claims amount to about 3% of the cost of medicine. But tort reform in the context of this plan is broader than than just medical malpractice claims.